Last Updated on July 8, 2026 by Don Gerig, RDCS
Quality improvement in echocardiography is often associated with accreditation. While accreditation is an important milestone, its greatest value lies in what happens between accreditation cycles. A meaningful quality improvement program helps laboratories continually improve image acquisition, interpretation, reporting, and ultimately patient care.
The Intersocietal Accreditation Commission (IAC) recognizes this by requiring accredited echocardiography laboratories to perform both technical peer review and interpretive peer review for each testing modality every quarter. These reviews are not simply administrative requirements—they are complementary processes that evaluate different parts of the diagnostic journey.
Understanding how technical and interpretive peer review work together is essential for building a stronger echocardiography quality program.
What Is Technical Peer Review?
Technical peer review evaluates the quality of the echocardiographic examination itself. The focus is on whether the sonographer acquired the images and Doppler data necessary to answer the clinical question accurately.
A technical review may evaluate:
- Image optimization
- Appropriate imaging windows
- Doppler acquisition and alignment
- Completeness of the examination
- Measurement technique
- Adherence to laboratory protocols
- Overall technical quality of the study
Technical peer review is not intended to criticize individual sonographers. Instead, it identifies opportunities to improve consistency, reinforce best practices, and support ongoing professional development.
What Is Interpretive Peer Review?
Interpretive peer review focuses on the physician’s interpretation of the examination.
Typical areas evaluated include:
- Appropriate Use Criteria
- Accuracy of findings
- Disease severity classification
- Consistency between measurements and interpretation
- Completeness of the final report
- Clinical interpretation of the examination
Interpretive review helps laboratories reduce diagnostic variability and promotes greater consistency among interpreting physicians.
Why Both Reviews Are Necessary
Technical and interpretive peer review evaluate two different components of the same examination.
A technically limited study may lead to an inaccurate interpretation despite excellent physician expertise. Likewise, a technically excellent examination can still result in reporting errors or inconsistent interpretation.
For example:
- A technically accurate left atrial volume measurement may be reported incorrectly.
- Doppler data may support severe aortic stenosis while the final report describes moderate disease.
- Excellent image acquisition may still result in discrepancies between measurements and the final interpretation.
Reviewing only one part of the process leaves potential opportunities for improvement undiscovered.
When both technical and interpretive peer review are performed together, laboratories gain a more complete understanding of where variability exists and how it can be addressed.
Looking Beyond Compliance
Many laboratories approach peer review simply to satisfy accreditation requirements. While meeting the IAC minimum standards is important, laboratories that gain the greatest benefit view peer review as an educational process rather than a compliance exercise.
Effective peer review can:
- Identify recurring technical challenges
- Reduce physician interpretation variability
- Standardize measurement techniques
- Improve report consistency
- Guide focused educational initiatives
- Support continuous quality improvement
Rather than asking, “Did we complete our quarterly peer reviews?” successful laboratories ask, “What did we learn, and how will we improve?”
Building a Stronger Quality Improvement Program
Technical and interpretive peer review are two of the most valuable tools available for improving echocardiography quality. When performed consistently and discussed in a constructive learning environment, they help laboratories move beyond simply maintaining accreditation toward building a culture of continuous improvement.
In future articles, we’ll explore common technical deficiencies identified during peer review, interpretive pitfalls that contribute to diagnostic variability, and practical strategies for transforming peer review from a quarterly requirement into one of your laboratory’s most valuable educational resources.
Related Articles
- IAC Accreditation Standards 2025 Updates: Top 5 Compliance Actions
- Smart Strategies for IAC Accreditation Success
- Accreditation Survey Results
- 6 Steps to Meeting New IAC QI Measures
- Time Saving Hacks While Improving Quality
- Helping Physicians See: Interpretive Variability
Related Services
Judith Buckland, MBA, RDCS, FASE
